The authors report their experience of 200 consecutive emergency admissions for iliopelvic uteric stones. 82 patients (41%) eliminated their stones with medical treatment. 118 patients (59%) required ureteroscopic treatment either by immediate basket extraction (n = 58) or by contact fragmentation (pulsed laser = 57, ultrasound = 1, electrohydraulic catheter = 2). 6 failures were observed and one case of distant ureteric stenosis was successfully treated by balloon dilatation. This therapeutic approach cured 187 (93.5%) of the patients of their stones within an average of 8 days (82 "spontaneous", 105 "endourological") with a mean hospital stay of 2.3 days and 2.7 days, respectively. Ureteroscopy had a success rate of 95% and appears to be the most effective treatment, but the medical option remains the basic treatment for stones of the lower ureter.